Rs.250/- (Rupees two hundred fifty) only FORM NO.1 (PRESCRIBED UNDER RULE 4) APPLICATION FOR PERMISSION TO CONSTRUCT/EXTEND OR TAKE INTO USE AS A FACTORY 1. (a) Applicant's Name:(IN BLOCK LETTER) (b) Calling : (c) Applicant's Address: 2. Full Name & postal address of the factory 3. (a) Situation of the Factory (b) State (c) District (d) Town or Village (e) Name of Sub-Division (f) Nearest Railway Station (g) Nearest Police Station (h) Nearest Streamer Ghat 4. Particulars of plan to be installed Signature of the applicant Note:- The application shall be accompanied by the following documents: 1 Flow chart of the manufacturing process supplemented by a brief description of the process in its various stages. 2 Plan in ammonia/blue print drawn to proper scale showing
